胃癌胃切除术后逆结肠Roux-en-Y重建与反结肠Roux-en-Y重建的生存效果比较

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of Gastroenterological Surgery Pub Date : 2024-02-18 DOI:10.1002/ags3.12779
Michitaka Honda, Motonari Ri, Takahiro Kinoshita, Hirofumi Kawakubo, Masaki Aizawa, Takeo Bamba, Satoru Matsuda, Hidetaka Kawamura, Mitsumasa Yoshida, Souya Nunobe
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引用次数: 0

摘要

胃切除术后的 Roux-en-Y (RY) 重建有两种方法:反结肠途径 (ACR) 和反结肠途径 (RCR)。目前还没有证据证明 ACR 可获得相当的长期生存率。这是一项多中心历史队列研究。研究对象为2006年1月至2012年12月期间接受开胃切除术和R0切除术的临床诊断为T3/4a和任何N期的胃腺癌患者。主要结果是ACR对总生存期的危险比,并通过倾向评分匹配和Cox比例危险模型对混杂因素进行了调整。经过匹配,最终分析纳入了 ACR 组和 RCR 组的 410 名患者。ACR的调整后危险比(95% CI)为1.148(0.870-1.492)。ACR 组和 RCR 组的五年生存率分别为 74.3% (69.5-78.4) 和 77.3% (72.3-81.2)。RY重建中提升空肠的路径并不影响长期生存率或术后并发症的发生率。ACR和RCR都是胃癌手术中可接受的RY重建方案。
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Comparison of the survival outcomes between retrocolic and antecolic Roux-en-Y reconstruction after gastrectomy for gastric cancer

Background

There are two methods of Roux-en-Y (RY) reconstruction after gastrectomy: the antecolic route (ACR) and retrocolic route (RCR). There is no evidence to support that the ACR achieves comparable long-term survival.

Methods

This was a multi-center historical cohort study. Patients diagnosed with clinical T3/4a and any N stage who underwent open gastrectomy and R0 resection for gastric adenocarcinoma between January 2006 and December 2012 were enrolled. The primary outcome was the hazard ratio of ACR for overall survival, with adjustment for confounding factors by propensity score matching, and a Cox proportional hazards model.

Results

A total of 1758 eligible patients were identified from the database. After matching, 410 patients in the ACR and RCR groups were included in the final analysis. The adjusted hazard ratio (95% CI) for ACR was 1.148 (0.870–1.492). The five-year survival rates in the ACR and RCR groups were 74.3% (69.5–78.4) and 77.3% (72.3–81.2), respectively. The short-term surgical outcomes of the two groups did not differ to a statistically significant extent.

Conclusion

The route used to lift the jejunum in RY reconstruction did not affect the incidence of long-term survival or postoperative complications. The ACR and RCR are both acceptable options for RY reconstruction during gastric cancer surgery.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
期刊最新文献
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